Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 07210 | Date 21/12/2019 |
| Token No | SM/19-20/15729 21/12/2019 | Serial | 037 Last Visit: 21/12/2019 |
| Patient Name | Mr. SK SIRAJ | Contact No | 6289568085 |
| Address | 36/A CHATRA MUSALMAN PARA , SERAMPORE | Age | 55 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||